Archives of Iranian Medicine
Volume:25 Issue: 7, Jul 2022

To evaluate the prevalence of type 2 diabetes mellitus (T2DM), impaired fasting glucose (IFG), and its cardio-metabolic risk factors in the southern Iranian adult population.

This is a population-based cross-sectional survey on 3944 middle-aged and elderly adults (35–70 years) from Bandare-Kong. The participants were recruited from 2016 to 2018 and the first phase data of the Bandare-Kong Cohort as a part of the PERSIAN Cohort were used for analysis.

Among the 3944 included adults, the age-adjusted prevalence of T2DM and IFG was 17.40% and 20.61%, respectively. Mean FPG was higher among those older than 55 years, females, rural residents, current cigarette smokers, hypertriglyceridemia, hypercholesterolemia, unemployed and low educational level in subjects with diabetes and pre-diabetes. T2DM and IFG were more prevalent in women and men, respectively. Also, those with higher waist circumference (WC), higher body mass index (BMI), lower educational levels, rural residents, former cigarette smokers, hypertension (HTN), hypercholesterolemia, hypertriglyceridemia and age older 45 years, had a higher T2DM and IFG prevalence. Multivariable regression analysis showed that older age, higher WC, HTN and hypertriglyceridemia and living in rural regions were statistically significant predictors of T2DM and pre-diabetes while BMI≥25 kg/m2 was the only significant risk factor for IFG.

The current study illustrated that T2DM and IFG have a high prevalence among the middle-aged and elderly adult Iranian population, particularly in rural dwellers. Hence, prevention strategies should be implemented to reduce diabetes and pre-diabetes, especially in rural areas.

Hypothyroidism is the most common hormonal deficiency worldwide; however, there is limited data about its prevalence in the children and adolescents of the Middle East.

The prevalence of hypothyroidism were calculated by dividing the number of patients purchasing levothyroxine in 1397 Solar-Hijri year (Correlate with March 2018-February 2019) by the population at risk (per 10000 persons). Data were collected from the Iran health insurance organization registration records and family physician databases of health vice-chancellor of Shiraz University of Medical Sciences.

The present study shows that the prevalence of levothyroxine treated population aged under 18 years is 13 in 10000 in the Fars province and it is more common in females (17 in 10000 in females versus 9 in 10000 in males). This study also revealed that the prevalence of hypothyroidism was different in various age groups and increased in older children and adolescents after pubertal ages. Also, an increase in the female: male ratio of prevalence was more obvious during and after puberty.

Our study showed that the prevalence of congenital hypothyroidism was 3/10000 in southern Iran. Also, the prevalence of hypothyroidism in children and adolescents was totally 13/10000 population, and this prevalence increased in older age and female gender. This prevalence was close to the data from iodine sufficient areas in Europe and the United States.

Hyperinsulinism is the most common cause of persistent or recurrent neonatal hypoglycemia that may result in neurological deficits. The treatment goal in these patients is prevention of hypoglycemia to decrease mortality and morbidity. This study was done to determine the clinical course and outcome in children with congenital hyperinsulinism (CHI) referring to Mofid Children’s Hospital from 2011 to 2017.

This study was done on 22 children with CHI referring to Mofid Children’s Hospital from 2011 to 2017. The demographic, perinatal, clinical, laboratory, imaging, pharmacological, treatment and follow up data of these children were collected and analyzed.

Among 22 children with CHI, the mortality rate was higher among those who received hydrocortisone versus those who did not receive hydrocortisone (46% versus 40%).

According to the results of this study, hydrocortisone had a negative impact on the outcomes of these children, which is important in the management of hypoglycemia. The clinical course and outcome of children with CHI was better with medical compared to surgical treatment.

Illicit tobacco trade is focused on Iran as a main target in the WHO’s eastern Mediterranean region. Serial studies of Cigarette Packs Survey with same method were conducted in Tehran between 2003 and 2015 to evaluate consumed smuggled cigarettes. This study as the fourth Cigarette Packs Survey is designed to indicate the trends of illicit cigarette trade in Tehran in the last two decades.

A cross-sectional household study was carried out in early 2021 in Tehran on 3042 persons who smoked at least one daily cigarette for a year. The sampling method was like the sampling method used in three previous studies. Participants aged≥15 years were asked to reveal their current cigarette pack, which was either legal cigarettes (having governmental label); or illegal cigarettes (without governmental label).

The subjects included 2536 males (83.4%) and the mean age was 39.9±12.1 years; 1854 subjects (60.9%) showed foreign cigarettes and 1188 (39.1%) showed domestic cigarettes; 2705 (88.9%) consumed legal cigarettes and 337 (11.1%) consumed illegal cigarettes. Consumption of illegal cigarettes by gender showed greater use of smuggled cigarettes in males (11.7%vs 8.1%). No significant differences were seen based on the marital and educational status in terms of illegal cigarettes prevalence.

Compare with previous studies, the trend of consumption of illicit cigarettes was decreasing in past two decades. This could be due to new regulation on monitoring cigarette distribution and changing illegal brands to legal as joint production.

With the continuous advancement of diagnostic methods, more and more early-stage Non-small cell lung cancer (NSCLC) patients are diagnosed. Although many scholars have devoted substantial efforts to investigate the pathogenesis and prognosis of NSCLC, its molecular mechanism is still not well explained.

We retrieved three gene datasets GSE10072, GSE19188 and GSE40791 from the Gene Expression Omnibus (GEO) database and screened and identified differentially expressed genes (DEGs). Then, we performed KEGG and GO functional enrichment analysis, survival analysis, risk analysis and prognosis analysis on the selected hub genes. We constructed a protein-protein interaction (PPI) network, and used the STRING database and Cytoscape software.

The biological process analysis showed that these genes were mainly enriched in cell division and nuclear division. Survival analysis showed that the genes of CEP55 (centrosomal protein 55), NMU (neuromedin U), CAV1 (Caveolin 1), TBX3 (T-box transcription factor 3), FBLN1 (fibulin 1) and SYNM (synemin) may be involved in the development, invasion or metastasis of NSCLC (P<0.05, logFC>1). Prognostic analysis and independent prognostic analysis showed that the expression of these hub gene-related mRNAs was related to the prognostic risk of NSCLC. Risk analysis showed that the selected hub genes were closely related to the overall survival time of patients with NSCLC.

The DEGs and hub genes screened and identified in this study will help us to understand the molecular mechanisms of NSCLC, and CEP55 expression affects the survival and prognosis of patients with NSCLC, and participates in tumor immune response.

This study aimed to investigate CURB-65, quick COVID-19 Severity Index (qCSI) and quick Sepsis Related Organ Failure Assessment (qSOFA) scores in predicting mortality and risk factors for death in patients with COVID-19.

We retrospectively analyzed a total of 1919 cases for whom the rRT-PCR assay for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. For mortality risk factors, univariate and multivariate logistic regression analyses were used. Receiver operator characteristics (ROC) analysis and Kaplan-Meier survival analysis were performed for CURB-65, qCSI and qSOFA scores.

The patients’ average age was 45.7 (21.6) years. Male patients accounted for 51.7% (n=992). In univariate analysis, some clinical variables including age over 65 years and comorbid diseases such as hypertension, chronic kidney disease, malignancy, lymphopenia, troponin, lactate dehydrogenase (LDH) and fibrinogen elevation were associated with the mortality rate. In multivariate logistic regression analysis: Neutrophil lymphocyte ratio (NLR) 3.3 and above (OR, 9.1; 95% CI, 1.9–42), C-reactive protein (CRP)30 mg/L and above (OR, 4.1; 95% CI, 1.2–13.6), D-dimer 1000 ng/mL and above (OR, 4; 95% CI, 1.5–10.7) and age (OR, 1.11; 95% CI, 1.04–1.18-year increase) were identified as risk factors for mortality among COVID-19 patients. The CURB-65 and qCSI scores exhibited a high degree of discrimination in mortality prediction (AUC values were 0.928 and 0.865, respectively). Also, the qSOFA score had a moderate discriminant power (AUC value was 0.754).

CURB-65 and qSCI scores had a high discriminatory power to predict mortality. Also, this study identified CURB-65, qCSI and qSOFA scores, NLR, CRP, D-dimer level, and annual age increase as important mortality risk factors.

Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) continues to be a worldwide healthcare problem. While our knowledge of the interaction of cancer and its management with COVID-19 mortality is gradually evolving, there are still many unanswered questions regarding the impact of COVID-19 on cancer and its prognosis. Several factors activated during COVID-19 have been implicated in tumorigenesis and the development of metastasis. Inflammation, hypoxia, reduced levels of angiotensin converting enzyme 2, elevated levels of Interleukin 6 and some other cytokines that are hallmarks of COVID-19 are capable of inducing tumor relapse and metastasis. On the other hand, there are reports that COVID-19 has been associated with cancer cure. Understanding the interaction between COVID-19 and tumor cells is essential for evaluating the potential long-term risks of COVID-19 in cancer patients, and for scheduling necessary preventive and therapeutic interventions. In this review, we briefly overview the potential impacts that COVID-19 might have on tumorigenesis and cancer relapse, as well as the role that COVID-19 might play in cancer remission and cure.

Unusual angiomatous or lymphangiomatous vascular malformations are rarely seen. One of them is lymphangioma (LA), which is a rare benign lymphovascular abnormality. LA is usually seen in the types of circumscriptum (or capillary), cavernous and cystic. Here, we report a unique case of LA with a patchy appearance. The patient presented due to unusual symptoms and eccentric clinical manifestation of the lesion. Here, we present a new lymphatic entity which was diagnosed as LA with its clinical, radiological and pathological findings. Written informed consent of the patient was obtained for this report. To the best of our knowledge this macular form of cutaneous LA has not been previously reported in literature. Macular LA should be kept in mind when faced with a colored long-term macular lesion on the skin.

The determinants and correlates of severe mental disorders are less understood compared to the common mental disorders, both in the world and in Iran. In this study, we aimed to identify a wide range of determinants of severe stress, severe anger, and severe sadness among Iranian population.

This study is part of a large nationwide cross-sectional survey entitled STEPs conducted using a comprehensive questionnaire to determine the prevalence of main preventable risk factors of non-communicable diseases (NCDs) in Iran by age and sex groups in 2016. In total, 30541 people aged 18+participated in this study. Univariate and multivariate logistic regression analyses were used to examine the associations between the dependent variable, which is severe mental disorders, and independent variables including socio-economic factors, lifestyle and selected NCDs.

The prevalence of severe stress, severe anger and sever sadness in the Iranian society was 33%, 35%, and 25%, respectively. Of the investigated socio-economic factors, being men, older, never married and living in rural areas were associated with significantly lower experience of severe mental disorders compared to other groups. For education, income and wealth index, there was no linear and clear pattern. Among lifestyle factors, being nonsmoker, having low physical activities, and higher intake of fruits and vegetables were found to be preventive of severe mental disorders. Additionally, having NCDs including hypertension, high cholesterol, diabetes and heart attacks were also significantly correlated with severe mental disorders.

determining factors associated with severe mental disorders in this study would help in raising people’s awareness on avoiding harmful factors, and taking healthier lifestyle such as quitting smoke, and consuming enough vegetables and fruits. Screening high risk people in terms of mental health could contribute to the reduction of mental disorders in the Iranian community.

Testing physicians and determining their professional qualifications have been significant issues in the educational and medical system of the Islamic civilization. The purpose of this study is to explain the views of Rhazes on how to test physicians in the book Al-Hawi Fi Al-Tibb. This library study has been done with descriptive-analytical method and using the keywords of medical test, medical ethics and medical history. Rhazes emphasizes various criteria by holding a comprehensive test to determine the competence of physicians with the aim of evaluating different aspects of their knowledge and attitude. He enumerates the provisions of the test in three sections: individual characteristics, theoretical and practical medical sections. The results show that Rhazes paid attention to all aspects related to a doctor’s personal and social habits and behavior and his relationship with the patients. A number of post-Rhazes physicians have also mentioned to the test of physician before hiring them but their content does not have the coherence of Rhazes’ statements. Most of the material mentioned in Al-Hawi Fi al-Tibb is still worth rethinking after hundreds of years. It is suggested that medical students and physicians use the ethical and professional points mentioned by this great scientist in his valuable book in order to make the high position of medical science more visible.